Are Breast Cancer Self-Exams Necessary?

Did you ever see this Far Side cartoon? A man is talking to his dog, Ginger: "Okay, Ginger, I’ve had it! You stay out of the garbage. Understand, Ginger? Stay out of the garbage, or else!” But what Ginger hears is "Blah blah GINGER blah blah blah blah blah blah blah blah GINGER blah blah blah blah blah...”

Now, it looks like I can drop the guilt. The Canadian Cancer Society last week followed the lead of the American Cancer Society, which last March revised its official stance on BSEs. In the past, the ACS recommended monthly BSEs following a particular method: “Lie down and place your right arm behind your head. Use the finger pads of the three middle fingers on your left hand to feel for lumps in the right breast. Use overlapping dime-sized circular motions of the finger pads to feel the breast tissue…”

Now, the ACS Web site says, “It is acceptable for women to choose not to do BSE or to do BSE occasionally.” Why the change?

Well, it seems studies have shown that whether or not women do BSEs has no bearing on whether or not they’ll die of breast cancer. The largest study to date involved 270,000 Canadian women, half of whom performed regular BSEs, half of whom didn’t. After 10 years of close monitoring, the breast cancer mortality rate was exactly the same in each group. The results of this study, and a few other long-term, large-scale studies, convinced the Canadian Cancer Society to drop their BSE recommendation.

But wait–we’re not off the hook. Both the ACS and CCS recommend that women become familiar with their breasts in whatever way is best for them, and then monitor and report any changes. Betsy Steinmark, an ACS spokesman, says, “We generally encourage women to get to know their breasts, but we tell women that self-exams are an option.”

Heather Logan, director of cancer control policy and information for the CCS, says, “You need to be aware of what your normal breast tissue is, and report any changes right away… Women still need to play an active role in their health.”

So, we need to pay attention to our breasts; just not in the regimented, one-size-fits-all way we’ve been taught in the past. I make a brief but fairly thorough exam part of my morning shower: up as far as my collarbone, under my armpits, a quick look in the mirror. Do this enough times, and your fingers develop muscle memory; you’ll notice when something feels wrong.

Rethink Breast Cancer, a Canadian cancer charity, encourages “Breast TLC” in place of BSE: “Touch your breasts, Look for changes, Check anything unusual with your doctor.” Sounds like a plan. And lucky for me, “TLC” is short enough that it won’t get lost in a lot of “blah blah blah.”